Red flags to screen for malignancy in patients with low-back pain
Abstract Background The identification of serious pathologies, such as spinal malignancy, is one of the primary purposes of the clinical assessment of patients with low-back pain (LBP). Clinical guidelines recommend awareness of “red flag” features from the patient’s clinical history and physical examination to achieve this. However, there are limited empirical data on the diagnostic […]
Red flags to screen for vertebral fracture in patients presenting with low-back pain
Abstract Background Low-back pain (LBP) is a common condition seen in primary care. A principal aim during a clinical examination is to identify patients with a higher likelihood of underlying serious pathology, such as vertebral fracture, who may require additional investigation and specific treatment. All ‘evidence-based’ clinical practice guidelines recommend the use of red flags […]
Spinal manipulative therapy for acute low-back pain
Abstract Background Many therapies exist for the treatment of low-back pain including spinal manipulative therapy (SMT), which is a worldwide, extensively practised intervention. This report is an update of the earlier Cochrane review, first published in January 2004 with the last search for studies up to January 2000. Objectives To examine the effects of SMT […]
Patient education for neck pain
Abstract Background Neck disorders are common, disabling, and costly. The effectiveness of patient education strategies is unclear. Objectives To assess the short- to long-term effects of therapeutic patient education (TPE) strategies on pain, function, disability, quality of life, global perceived effect, patient satisfaction, knowledge transfer, or behaviour change in adults with neck pain associated with […]
Manual material handling advice and assistive devices for preventing and treating back pain in workers
Abstract Background Training and the provision of assistive devices are considered major interventions to prevent back pain and its related disability among workers exposed to manual material handling (MMH). Objectives To determine the effectiveness of MMH advice and training and the provision of assistive devices in preventing and treating back pain. Search methods We searched […]
Workplace interventions for neck pain in workers
Abstract Background Musculoskeletal disorders are the most common cause of disability in many industrial countries. Recurrent and chronic pain accounts for a substantial portion of workers’ absenteeism. Neck pain seems to be more prominent in the general population than previously known. Objectives To determine the effectiveness of workplace interventions (WIs) in adult workers with neck […]
Behavioural treatment for chronic low-back pain
Abstract Background Behavioural treatment is commonly used in the management of chronic low-back pain (CLBP) to reduce disability through modification of maladaptive pain behaviours and cognitive processes. Three behavioural approaches are generally distinguished: operant, cognitive, and respondent; but are often combined as a treatment package. Objectives To determine the effects of behavioural therapy for CLBP […]
Combined chiropractic interventions for low-back pain
Abstract Background Chiropractors commonly use a combination of interventions to treat people with low-back pain (LBP). Objectives To determine the effects of combined chiropractic interventions (that is, a combination of therapies, other than spinal manipulation alone) on pain, disability, back-related function, overall improvement, and patient satisfaction in adults with LBP, aged 18 and older. Search […]
Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain
Abstract Background Low-back pain with leg pain (sciatica) may be caused by a herniated intervertebral disc exerting pressure on the nerve root. Most patients will respond to conservative treatment, but in carefully selected patients, surgical discectomy may provide faster relief of symptoms. Primary care clinicians use patient history and physical examination to evaluate the likelihood […]
Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain
Abstract Background Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as a therapeutic adjunct to the pharmacological management of pain. However, despite widespread use, its effectiveness in chronic low-back pain (LBP) is still controversial. Objectives To determine whether TENS is more effective than placebo for the management of chronic LBP. Search […]